When surgical or local therapies are not possible, systemic therapy with sorafenib is usually the recommended first line therapy.[33] Sorafenib was the first drug approved for systemic treatment of advanced HCC.[16] For the use of sorafenib in recurrent HCC after LT, a potential therapeutic benefit has also been shown in several studies, especially in combination with mammalian target of rapamycin inhibitors.[22,23,33–35] In our case, the patient was treated systemically with sorafenib. The gene discussed is MTOR; the disease is hepatocellular carcinoma.